Midterm surgical treatment outcomes of unstable distal radius fractures

Yeghiazaryan K.A.

N.N. Priorov National Medical Research Center of Traumatology and Orthopaedics, Moscow, Russia

Ratiev A.P.

N.N. Priorov National Medical Research Center of Traumatology and Orthopaedics, Moscow, Russia

Grigor'ev A.V.

FGBU "Moskovskiĭ NII glaznykh bolezneĭ im. Gel'mgol'tsa" Minzdrava Rossii

Germanov A.V.

N.N. Priorov National Medical Research Center of Traumatology and Orthopaedics, Moscow, Russia

Danilov M.A.

A.S. Loginov Moscow clinical scientific and practical center, Moscow, Russia

Chebotarev V.V.

Medical University «Stavropol State Medical University» Ministry of Health of the Russian Federation, Stavropol, Russia, 355002

Midterm surgical treatment outcomes of unstable distal radius fractures

Authors:

Yeghiazaryan K.A., Ratiev A.P., Grigor'ev A.V., Germanov A.V., Danilov M.A., Chebotarev V.V.

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Journal: N.N. Priorov Journal of Traumatology and Orthopedics. 2019;(1): 17‑26

DOI: 10.17116/vto201901117

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To cite this article:

Yeghiazaryan KA, Ratiev AP, Grigor'ev AV, Germanov AV, Danilov MA, Chebotarev VV. Midterm surgical treatment outcomes of unstable distal radius fractures. N.N. Priorov Journal of Traumatology and Orthopedics. 2019;(1):17‑26. (In Russ.)
https://doi.org/10.17116/vto201901117

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Background. Fracture of the distal radius is the most common injures bones of the forearm. Multifragmentary articular injures have occupied a special place among all fractures of the distal radius This factor due to the severity of the injury wrist joint, young patients and difficult rehabilitation. Purpose of study: Improvement results surgical treatment unstable fractures of the distal radius. Patients and methods. All patients were depended into two groups: The first group consisted of 34 patients. The first stage of treatment include close reduction and external fixations. If after external fixation we have persisting fractures dislocation, we take conversion external fixation, open reduction and plate fixation. The second group were included 30 person. In this group we take open reduction and plate fixation. Results. 6 or 12 month after surgery in 1 group we have receiver 87% excellent results. In the the second group we have received 77% excellent results. In the first group 2 cases have slow fractures consolidation, infection complication not found. In the second group we have 2 complication: CRPS and infection. Conclusion. Results in two groups of patients are assessed as good and excellent. The results of the study showed that external fixation in first stage of treatment allows to achieved better restoration radiocarpal joint anatomy (except for type B fractures), and without secondaly displacement tendency. The last fact is very important for patient with delayed the second stage of treatment. This patients with multiple injuries, open fractures and presence of an infected wound and etc. The second stage of treatment consisted of open reduction and plate fixation. Achieved full anatomy restoration radiocarpal joint with possible early rehabilitation. Conflict of interest: the authors state no conflict of interest Funding: the study was performed with no external funding

Keywords:

fracture of the distal radius

unstable injures

external fixation

two-stage method of treatment

Authors:

Yeghiazaryan K.A.

N.N. Priorov National Medical Research Center of Traumatology and Orthopaedics, Moscow, Russia

Ratiev A.P.

N.N. Priorov National Medical Research Center of Traumatology and Orthopaedics, Moscow, Russia

Grigor'ev A.V.

FGBU "Moskovskiĭ NII glaznykh bolezneĭ im. Gel'mgol'tsa" Minzdrava Rossii

Germanov A.V.

N.N. Priorov National Medical Research Center of Traumatology and Orthopaedics, Moscow, Russia

Danilov M.A.

A.S. Loginov Moscow clinical scientific and practical center, Moscow, Russia

Chebotarev V.V.

Medical University «Stavropol State Medical University» Ministry of Health of the Russian Federation, Stavropol, Russia, 355002

List of references:

Izmalkov S.N., Semenkin O.M., Bratijchuk A.N. Diagnostics and operation treatment unstable fractures of distal radius. Samara: Book publishing house; 2016. (In Russ.)
Pechlaner S., Gabl M., Lutz M., Krappinger D., Leixnering M., Krulis B., Ulmer H., Rudisch A. Distale Radiusfrakturen: Atiologie, Behandlungsmethoden und Ergebnisse. Handchir Mikrochir Plast Chirurgie. 2007;39:19-28.
Slutsky D.J., Osterman L.A. Fractures and injuries of the distal radius and carpus: the cutting edge. Philadelphia, PA: Elsevier; 2009.
McKay S.D., MacDermid J.C., Roth J.H., Richards R.S. Assessment of complications of distalradius fractures and development of a complication checklist. J Hand Surg (A). 2001;26(5):916-92.
Egiazaryan K.A., Magdiev D.A. «Optimization of providing specialized care to patients with hand injuries and diseases» N.I. Pirogov Journal of Medical Research. 2012;2:77-80. (In Russ.)
Ryudi T.P., Bakli R.E’., Moran K.G. AO — Principles of Fracture Management — Second explanded edition by AO Publishing. Moscow: Vassa-Media; 2007. (In Russ.)
Muller A.O. Classification of Fractures — Long Bones. Switzerland: AO Publishing; 2007.
Melone C.P. Distal radius fractures patterns of articular fragmentation. Hand Clin. 1993;24(2):239-53.
Slutsky D.J., Osterman A.L. Fractures and injuries of the distal radius and carpus: the cutting edge. 1st ed. Elsevier; 2009.
Fernandez D.L., Jupiter J.B. Fractures of the distal radius: a practical approach to management. 2nd ed. Springer; 2002.
Rikli D.A., Regazzoni P. The double plating technique for distal radius fractures. Tech Hand Up Extrem Surg. 2000;4(2):107-14.
Izmalkov S.N., Semenkin O.M. Operation treatment unstable fractures of distal radius. Methodical recommendation. Samara: SamGmu; 2005. (In Russ.)
Sergeev S.V., Zagorodnij N.V., Abdulhabirov M.A., Grishanin O.B., Karpovich N.I., Papoyan V.S. Actual methods of fractures management in Orthopedic trauma syrgery. Training manual. Moscow: RUDN; 2008. (In Russ.)
Fernandez D.L., Jupiter J.B. Fractures of the distal radius: a practical approach to management. 2nd ed. Springer; 2002.
Slutsky D.J., Osterman A.L. Fractures and injuries of the distal radius and carpus: the cutting edge. 1st ed. Elsevier; 2009.
Jonson D.G., Amendola A.A., Barber F.A. et al. Operative arthroscoly. Part II. translate by S.V. Ivannikova. Moscow: Published Panfilova; 2015. (In Russ.)
Skoroglyadov A.V., Korobushkin G.V., Alqatf H.M. The treatment of fractures of distal radius by palmar plate with angular stability» N.I. Pirogov Journal of Medical Research. 2009;6:32-4. (In Russ.)
Sergeev S.V., Zagorodnij N.V., Abdulhabirov M.A., Grishanin O.B., Karpovich N.I., Papoyan V.S. «Actual methods of fractures management in Orthopedic trauma syrgery»: Training manual. Moscow: RUDN; 2008. (In Russ.)
Arora R., Lutz M., Hennerbichler A., Krappinger D., Espen D., Gabl M. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma. 2007;21(5):316-22.
Rampoldi M., Marsico S. Complications of volar plating of distal radius fractures. Acta Orthop Belg. 2007;73(6):714-9.
Soong M., van Leerdam R., Guitton T.G., Got C., Katarincic J., Ring D. Fracture of the distal radius Risk factors for complications after locked volar plate fixation. J Hand Surg Am. 2011;36(1):3-9.
Rozental T.D., Blazar P.E. Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg Am. 2006;31(3):359-65.
Thielke S.H., Spors-Schrödter L., Wasgner T. et al. Winkelstabile Plattenosteosynthese am distalen Radius. Lösung einer Problemfraktur Akt Traumatol. 2002;32:245-50.
Sahu A., Batra S., Charalambos C., Ravenscroft M. Re-operation for metalwork complications following the use of volar locking plates for distal radius fractures; experience of a general trauma unit in UK. Orthopaedic Proceedings; 2018.
Windolf J., Hakimi M., Schädel-Höpfner M. Ergebnisse der palmaren winkelstabilen Plattenosteosynthese am distalen Radius. Trauma Berufskrankh. 2008;10(2):236-40.
Lattmann T., Dietrich M., Meier C., Kilgus M., Platz A. Comparison of 2 surgical approaches for volar locking plate osteosynthesis of the distal radius. J Hand Surg (A). 2008;33(7):1135-43.
Drobetz H., Kutscha-Lissberg E. Osteosynthesis of distal radius fractures with a volar locking screw plate system. Int Orthop. 2003;27:1-6.
Prommersberger K.-J., Moossavi S., Lanz U. Ergebnisse der Korrekturosteotomie fehlverheilter Extensions frakturen der Speiche an typischer Stelle. Handchir Mikrochir Plast Chir. 1999;4:234-40.
Bejdik O.V., Kotel’nikov G.P., Ostrovskij N.V. «External fixation by fracture management». Samara: Perspectiv; 2002. (In Russ.)
Marcheix P.S., Dotzis A., Benko P.E. Extension fractures of the distal radius in patients older than 50: a prospective randomized study comparing fixation using mixed pins or a palmar fixed-angle plate. J Hand Surg Eur Vol. 2010;35:646-51.
Khominets V.V., Tkachenko M.V., Syrtsov V.V., Ivanov V.S. Comparative analysis of treatment technique in patients with distal radius fractures. Travmatologia I ortopedia Rossii. 2015;2:5-15. (In Russ.)
Li-hai Z., Ya-nan W., Zhi M., Li-cheng Z., Hong-da L., Huan Y., Xiao-xie L., Pei-fu T. Volar locking plate versus external fixation for the treatment of unstable distal radial fractures: a meta-analysis of randomized controlled trials. J Surg Res. 2015;193(1):324-33.
Perren S.M. Evolution and rational of locked internal fixator technology. In-troductory remarks. Injury. 2001;32(2):39.
Rikli D.A., Regazzoni P. Fractures of the distal end of the radius treated by internal fixation and early function: a preliminary report of 20 cases. J Bone Joint Surg Br. 1996;78:588-92.
Dwyer C.L., Crosby N.E., Cooney T., Seeds W., Lubahn J.D. Treating Unstable Distal Radius Fractures With a Nonspanning External Fixation Device: Comparison With Volar Locking Plates in Historical Control Group. Am J Orthop. September, 2017;46(5):E344-E52.
Richard M.J., Wartinbee D.A., Riboh J., Miller M., Leversedge F.J., Ruch D.S. Analysis of the complications of palmar plating versus external fixation for fractures of the distal radius. J Hand Surg Am. Oct, 2011;36(10):1614-20. https://doi.org/10.1016/j.jhsa.2011.06.030.
Wright T.W., Horodyski M., Smith D.W. Functional outcome of unstable distal radius fractures: ORIF with a volar fixed-angle tine plate versus external fixation. J Hand Surg Am. Mar, 2005;30(2):289-99.
Margaliot Z., Haase S.C., Kotsis S.V., Kim H.M., Chung K.C. «A meta-analysis of outcomes of external fixation versus plate osteosynthesis for unstable distal radius fractures». J Hand Surg Am. Nov, 2005;30(6):1185-99.
Wei D.H., Raizman N.M., Bottino C.J., Jobin C.M., Strauch R.J., Rosenwasser M.P. Unstable distal radial fractures treated with external fixation, a radial column plate, or a volar plate. A prospective randomized trial. J Bone Joint Surg Am. Jul, 2009;91(7):1568-77. https://doi.org/10.2106/JBJS.H.00722.
Mel’nikov V.S., Korshunov V.F. Methods of surgical treatment malunion of the distal radius. Medical Journal Lechebnoe delo. 2008;3:78-84. (In Russ.)
Golubev I.O., Maksimov A.A., Shiryaeva G.N., Merkulov M.V., Bushuev O.M., Kutepov I.A. «Complications of nonoperative treatment fracture distal radius. III All-Russian Congress of hand surgeons «The actual technology of diagnostics, treatment and rehabilitations in case of damage to the upper limb». Thesis of reports. Moscow; 2010. (In Russ.)
Fitzpatrick S.K., Casemyr N.E., Zurakowsky D., Day C.S., Rozental T.D. The Effect of Osteoporosis on Outcomes of Operatively Treated Distal Radius Fractures. J Hand Surg. 2012;37(10):2027-34.
Dy C.J., Wolfe S.W., Jupiter J.B., Blazar P.E., Ruch D.S., Hanel D.P. Distal Radius Fractures: Strategic Alternatives to Volar Plate Fixation. Instr Course Lect. 2014;63:27-37.

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